Raj. CHO - 2023: What is the main cause of Enteric fever?

Raj. CHO - 2023

Applied Microbiology & Infection control

Easy

Appeared in: Raj. CHO - 2023

Explanation

Enteric fever, also known as typhoid fever, is a systemic disease caused by the bacterium Salmonella enterica serotype Typhi (S. typhi).
Paratyphoid fever, a similar but often milder illness, is caused by S. paratyphi A, B, or C.
Humans are the only host for S. typhi, and transmission occurs through the fecal-oral route, typically via ingestion of contaminated food or water.
After ingestion, the bacteria penetrate the intestinal mucosa, multiply within the reticuloendothelial system (liver, spleen, bone marrow), and then spread into the bloodstream, causing systemic symptoms.

Option A: Escherichia coli (E. coli) is a common bacterium that can cause various infections, most notably gastroenteritis (diarrhea) and urinary tract infections (UTIs), but it does not cause enteric fever.
Option B: Leishmania is a protozoan parasite, not a bacterium. It is transmitted by the bite of infected sandflies and causes the disease leishmaniasis (e.g., kala-azar or visceral leishmaniasis).
Option D: Coxiella burnetii is the bacterium responsible for Q fever, a zoonotic disease typically transmitted to humans from infected animals like cattle, sheep, and goats.

Visual 1: Infographic - A diagram illustrating the fecal-oral route of transmission for enteric fever, showing how contaminated water, food, and poor hygiene contribute to its spread.
Visual 3: Clinical Photo - An image of 'rose spots,' the faint, salmon-colored maculopapular rash that can appear on the trunk of patients with enteric fever.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Causative agent of Enteric Fever (Typhoid) as background academic context rather than a clinical decision trigger.
Nurses must implement strict standard and contact precautions for patients with enteric fever to prevent nosocomial spread, especially through proper disposal and disinfection of excreta.
A key nursing assessment is monitoring for severe complications like intestinal perforation (sudden severe abdominal pain, rigidity) or hemorrhage (melena, drop in blood pressure), which are medical emergencies requiring immediate intervention.
Patient education on safe food and water practices is a crucial preventive measure, especially for individuals traveling to endemic areas.

How to Approach the Question

First, identify the key term in the question: 'Enteric fever'. Recognize that this is the medical term for typhoid fever.
Second, access your knowledge of microbiology and infectious diseases. This is a factual recall question asking for a specific pathogen.
Third, evaluate each option by linking the pathogen to the disease it causes.
Fourth, select Salmonella typhi as it is the well-established causative agent of enteric (typhoid) fever.
Finally, eliminate the other options by confirming they cause different diseases: E. coli (UTIs, gastroenteritis), Leishmania (leishmaniasis), and Coxiella burnetii (Q fever).

Concept Tested & Keywords

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Textbook of Applied Microbiology Including Infection Control and Safety (Second Edition) p. 54-65